Pin Site Update

The pin site we were concerned about has improved quite a bit. Brooke's hydrogen peroxide magic did the trick and cleaned it up before we went into the office today. The oozing you see is probably plasma. The fact that it's clear is a good sign.

They need to be cleaned up a little bit more. You can see some scabs in some of the threading, particularly in the left pin.

I'm making sure to capture close-up images of the pin sites so we can track any significant changes to their appearance. So far, everything looks great.

Orthopedic Foot and Ankle Center Friendships

Here we are at the end of August -- seven months after hitting a tree with a snowboard -- and this is our first picture with Dr. Matthew Buchanan.

Dr. Buchanan is an excellent surgeon and, more importantly, consistently professional and personable. Brooke and I both highly respect him and everyone on staff at the Orthopedic Foot and Ankle Center. We just wish we could stop hanging out at hospital operating rooms and the clinic.

We didn't see Josie in the office today, so we didn't get a chance to grab her for some forced blog photography.

Dr. Buchanan's nurse, Janelle, has been awesome handling all of our anxious calls and questions. Thanks for all of the help for the last six months and thanks in advance for all of our future calls and questions.

Our other doctor, the lovely and always smiling Dr. Evetta Borden, refused to get her picture taken today because, as she put it, she was having a bad hair day. Ridiculous! Apparently, she's simply postponing it until next week.

I'm not leaving the office next week until we get a picture together.

Meet Ashley (on the left) and Amy (on the right). We've been hanging out since February. Both of these lovely ladies are highly skilled at putting up with my crap while dressing my ankle wounds and taking x-rays.

We just recently gave our new friends at the clinic the address to the blog. To my surprise, they've been reading it. So, Amy, Ashley -- if you guys are reading this stupid post, we hope your office inventory party kicked as much butt as it sounded like it would.

If you got tired of counting Casttoos, just remember Casttoos are totally awesome.

What, is his cast on fire? No way!

If you're on Twitter, you can follow the Orthopedic Foot and Ankle center at @footankledc.

In all our pictures I'm sporting my Marshall Brewing Company t-shirt. They're one of a few Tulsa-based brewing companies. The owner and our friend, Eric, was with us on the ski trip when I had the accident.

Eric was a top runner for most epic mustache on the trip.

Egg Recall Strikes Pelvis

My pelvic incision has felt a little neglected on the blog. If you recall, I bled like a stuck pig during surgery and developed a massive hematoma underneath my skin. The bruise is gone now.

But, especially from this angle, it appears as though a giant egg has been installed in place of the hole they left in my iliac crest.

Of all five incisions I had from my third surgery, this one bothers me the most. It feels like a sore or bruised muscle. It's not very aesthetically pleasing, either. It's one more lump to my already lump packed situation. And as 2010 has gone so far, I've not had many opportunities to address the lumpiness.

This got me thinking. As years go, 2010 has not been a good one for the team. Let's recap some of the truly amazing events of this otherwise injury plagued year.

February 4th: Pants on the Ground Single Released by Larry Platt

Yes, there is a single of this amazing song that you can buy right now.

March 19th: Justin Bieber Releases My World 2.0

Remember -- if anyone asks, this teen heart throb broke my ankle.

June 23rd: Kansas City Royals Lose Series 2-1 to the Washington Nationals

My team is so awesome, they occasionally forget to include the letter 'O' in the players' jerseys.

August 30th: I Follow Rod Blagojevich on Twitter Because He's Insane

We're all jealous of the hair.

That's about it. I can't think of anything else important or significant that's happened this year nationally or anywhere else in the world.

I can't wait to see what @governorrod tweets next! Hopefully it's as good as this.

Snowboarder vs. Brett Favre

For those of you that follow the NFL, you know that Brett Favre has already had three surgeries on his left ankle. While the Iron Man of the NFL may hold the most consecutive starts record, he barely ties me in the ankle operations category (presently this record is not officially tracked by the NFL Records Office). Brett's most recent operation in May was to remove bits and pieces from several bone spurs.

From this article by Peter King in Sports Illustrated today,

Noted orthopedist Dr. James Andrews did the most recent surgery May 22..."They took out a cup full of stuff -- bone and all these other loose bodies," Brett Favre said Saturday night. "Deanna watched and told me, 'If you don't feel a lot better, I'll be shocked.' "

Brett called his last surgery a "grease fitting." I might have to get my own grease fittings in the future.

The quarterback that preceded Brett, Don Majkowski, went out of a Packers game in 1992 with a torn ankle ligament. Brett filed in his spot and started every single game after that injury until 2007.

I found out today from The Professor, John Clayton, that Don Majkowski had three surgeries on his ankle to treat bone spurs while he was in the NFL (like Brett, Don was only able to tie my record while he was a player). He had eight more operations after he retired and ended up with an ankle fusion.

Favre and I potentially face the same fate as Don. This puts us in an elite, select, special group of top American athletes that have suffered injuries due to the sports we love. After my fourth surgery three months from now, I'll be leading Brett Favre in the ankle surgery category. I'm pretty pumped about that.

Might need to make a t-shirt.

My appointment to see Dr. Buchanan has been moved up to tomorrow in order to take a look at the pin site. I looked at it today and noticed a significant improvement in its appearance. But it's still better to take every precaution this time around, so I'm glad I'm going in a day earlier.

More Awesome Pictures!

Tonight was the first time to reveal the ankle to everyone at home. Guess what? It's still really gross. We believe that the most proximal pin in my tibia might be infected, so we used some diluted hydrogen peroxide to clean it and applied ample amounts of antibacterial ointment. I'll call the doctor's office tomorrow to follow up on it. Fortunately, I see them again Wednesday.

Onto the awesome pictures...

American Health Care

Brooke and I just got our bill from the Virginia Hospital Center for our three-day stay. It came in at just under $40,000 and our insurance covered all of it. We'll still get a separate bill from Dr. Buchanan, his PA, Josie, and the anesthesiologist.

But I decided to quickly run through how much our insurance company has been billed since my accident. Here's the run down:

• $2,429 - Breckenridge Emergency Clinic
• $1,691 - Ambulance to St. Anthony's Summit Medical Center
• $651 - Emergency Department at St. Anthony's Summit Medical Center
• $73,512 - First Hospital Stay at St. Anthony's Summit Medical Center
• $3,345 - Surgery by Dr. Peter Janes
• $669 - Dr. Peter Janes' Physician Assistant
• $2,000 - Anesthesia at St. Anthony's Summit Medical Center
• $31,348.50 - Second Hospital Stay at Virginia Hospital Center
• $1,650 - Anesthesia at Virginia Hospital Center
• $5,100 - Surgery by Dr. Matthew Buchanan
• $38,272.60 - Third Hospital Stay at Virginia Hospital Center
• $1,829 - Radiology Imaging and Reports
• $200 - Wheelchair Rentals
• $4,000 - Bone Stimulator
• $5,000 - Wound Vacuum
• $4,000 - Apligraf
• $1,594 - Lab Work
  
• $4,600 - Dr. Evetta Borden, Podiatrist
• $2,135 - Physical Therapy at Sports Therapy and Rehabilitation Clinic
• $264.41- Dr. Didace Kabatsi, Family Physician
• $2,694 - Dr. Matthew Buchanan, Office Visits

Grand total: $187,000! I still have several office visits to go and a fourth surgery. This also doesn't count all of the costs we've incurred for home supplies, medications, and taxis.

Oh. And the giant hole I ripped in our comforter with my satellite dish the other night. I did that, too.

Oops.

Gifts

Back in February, our friend in Egypt sent us one of many of his wonderful gifts. Of course, Brooke took it away from me instantly.

Well, we got another gift a few days ago in the mail.

As you can see, our second bell has already been placed out of my reach five feet away. Keep them coming, Jim!

We got another gift from my Aunt Kathy.

The only thing that's out of place with this bobble head statue is my right ankle isn't in an external fixator.

Bear Trap

I mentioned in my last post that I experienced my first public outing with my new hardware on Wednesday. As you might imagine, the dish attracted a significant amount of strange or frightened looks as well as several inquiries as to how I ended up like this.

I always try to be as pleasant and as nice to people as I can, but quite honestly it can get a little repetitive and tiring to tell the same story over and over. And to be fair, most people are just being polite. They don't want to sit around and talk about my stupid recovery for an hour. The story is way too long.

I need a new way of telling the story to people. One that's short, to the point, and easy to repeat without getting old. Or maybe I need a new story altogether.

Chris came up with a great idea, Story #1: The Bear Trap.

This is my favorite suggestion so far. When someone asks me what happened, I can simply shrug and state point blank, "I stepped in a bear trap this morning. What, does it look bad? Do you think I should see someone about it?" It's so simple and to the point. Hopefully people don't think I'm being a jerk. It's all in the delivery.

Another idea is Story #2: My Nephews Got Carried Away with an Erector Set.

This one came to me because the external fixator looks exactly like an erector set. The only thing that makes this story unbelievable is I don't think they make these sets anymore. Legos have been the new hotness for the last several decades. "What happened to your leg?" "Oh, my nephews Jacob and Joshua found my great grandfather's erector set and went to town."

My problem with these stories is that they lack excitement. If I'm going to make something up, why not introduce a little bit of drama and suspense?

Story #3: I Fought a 1,200 lb Grizzly Bear in Montana. And I did it on purpose. I was attempting to tame him to be my pet and servant on a bet. While I suffered this injury to my ankle, I won the bet. I like the Montana part. Makes the story feel rustic and outdoorsy.

I kind of like the idea of fighting wild, insanely strong, vicious animals.

Story #4: I Fought a Rare and Hungry White Siberian Tiger Underwater. I was underwater. I was blindfolded. And I solved a Rubik's cube in record time.

But, now that I think about it, I'm probably going too far with the Rubik's cube part. I have no idea how to solve those things. I usually cheat by moving the colored stickers.

But why limit myself to animals that currently exist?

Story #5: I Was Bucked Off of an Angry Tyrannosaurus Rex. There's a very small chance people might not believe this story. They might roll with it, though, if they think I'm on enough pain pills.

How about, Story #6: I Defeated Godzilla. Curious tourists from Japan would hopefully be very appreciative of me defeating their arch nemesis. To walk away from a fight with Godzilla with only a broken ankle would be a blessing. But then I'd have to answer, "Who provoked the fight?" Obviously, Godzilla is a hot head. He's always starting trouble. Unless he's fighting another huge beast to defend Japan. I've been called a huge beast. On second thought, this idea is terrible.

How about ridiculous ideas that stop all further conversation?

Story #6: I Broke My Ankle While Knitting. This makes no sense to anyone, but who knows, knitting could be dangerous.

Story #7: I Broke My Ankle After Looking at Amy Winehouse. For my parents and family that don't know who this singer is, she used to look a lot better. But, she made some bad decisions and started doing drugs. As you can see, the drugs were a really, really poor idea on her part. I think this might be the most believable made-up story so far.

Story #8: Too Much Facebooking. I'm not actually on Facebook, but everyone else in the world appears to be. Brooke's parents are in town this week with us. Her Mom was on Facebook for a solid two hours last night.

Did you know you can grow a farm on Facebook? Did you know people actually like growing plants on their virtual farm? This is clearly enough evidence to suggest it's very possible to severely break an ankle while Facebooking.

Story #9: I Got My Butt Kicked by Justin Bieber. I don't know much about this seven-year-old singer, but I know enough to understand that you don't want to mess with him. He's a thug and you don't want to get on his bad side. That said, I still follow him on Twitter. What's up, @justinbeiber!

This leads me to my last idea, Story #10: Helped Defeat Global Terrorism. Obviously, my ankle cannot take all of the credit. That's just stupid. Our men and women in uniform rightfully deserve the credit. But maybe when people ask me what happened, I can just say, "I protected America."

Of course, the last thing I want to do is pose as someone who was injured while deployed overseas. So I'll probably switch it up between The Bear Trap and Amy Winehouse.

Stimulation

As of yesterday, I'm the proud owner of a new bone stimulator. I haven't had my bones stimulated in years.

Just what exactly does this thing do? It emits ultrasonic waves over the fracture site. These waves deliver mechanical pressures to the bone tissues in order to promote bone growth. They do not help in situations where there is a significant gap in the fracture, like my fibula. But this should help with the tibia fracture now that I have a piece of my pelvis filling in the large gap.

The device still sounds like magic, but there are studies that show improved healing when these devices are used correctly. According to one of the research papers I found on Google Scholar,

"Although regarded with skepticism by many physicians, there is abundant evidence from clinical studies of the effectiveness of these treatments. In addition to dozens of retrospective reports, randomized, prospective, double-blind controlled trials have shown the efficacy of electrical stimulation for nonunion and ultrasound for speeding healing."

How do you use a bone stimulator correctly? I have to wear it for 30 minutes every day for about three months. I picked 9:00PM as my scheduled treatment time. The representative I met with at the doctor's office recommended I do the treatment at the same time every day in order to ensure I don't miss a treatment.

Speaking of representatives, I ran into the Apligraf representative at the clinic yesterday. She recognized me and looked at my ankle in amazement. I had to explain to her that we destroyed her product.

The package that it comes in makes it look like it's extremely expensive. That's because it is. It costs over $4,000. Fortunately my insurance covered 90%. At some point I need to add up the costs of my injury.

This is the controller. It's extremely easy to use. You just press and hold the button to turn it on. It's pre-programmed for a 30 minute treatment.

The transducer is small enough to fit underneath my external fixator. This is the smallest model they make. At first, I was going to be provided with a much larger device. That's why I didn't receive my stimulator right after my surgery.

Yesterday was my first day out in public with my external fixator. I got a ton of odd looks from people. Several curious people asked me what happened. I'll be honest, I was getting tired of telling the story after the fifth or sixth time. I need to come up with a fast way to tell the story, or maybe come up with a new accident to make it interesting.

The Reveal

Today was the first time I got a chance to see the wounds from the August 16th surgery. Dr. Buchanan said I could return to work as soon as I felt up to it. That's great to hear, because I'm running low on leave.

I also received my bone stimulator. It's a small device I wear on the ankle for 30 minutes a night to stimulate growth. I have no idea how it works, so I'll have to do some research to figure out why it's not the same thing as magnetic healing bracelets.

Here's the pelvic incision. I broke out in some kind of rash, but now that I'm no longer wearing a bandage here, that should go away. You can tell that the person (Josie) that sewed this incision up was just a little bit of a perfectionist! Look how perfectly spaced out the stitches are.

The top incision was stitched together without any staples. The stitch work here doesn't look pretty, but it gets the job done.

The fibula incision was put back together with staples.

I have a small amount of swelling, but all in all my foot looks great.

You can see one of the two incisions on the left side of my ankle where two screws were removed.

Here are two of the incisions where two screws were removed.

This is the right side of my foot with four pin sites.

The top two large pins were oozing a little bit of blood.

Here's the top incision. Dr. Borden came in to see all the work we did get destroyed. Everyone in the clinic has just been awesome. I go back again next week just to make sure things are healing nicely.